Spine Doctors’ Group To Require Disclosure of Device Maker Payments to Surgeons

The North American Spine Society has announced a requirement that spine surgeons disclose all financial ties with medical device companies, as well as the related dollar amounts, the Wall Street Journal reports. NASS, which has more than 5,000 members, said the measure will apply to all doctors who present studies at future medical conferences. The move, a "rare step" for such an industry group, is in response to pressure from lawmakers, prosecutors and lawsuits from former employees alleging improper relationships between device firms and doctors, according to the Journal. Such relationships can involve payments to doctors that are worth "millions of dollars," the Journal reports.

NASS said the rule "is not a voluntary guideline, but a binding covenant which applies to all relationships engaged in by all participants in all" activities of the society. Failure to disclose a relationship with a device firm would be a "sanctionable offense," according to NASS. The sanctions would affect only surgeons' membership in the group, not their ability to practice.

NASS ethics committee Chair Marjorie Eskay-Auerbach said, "It just became clear that more transparency is better." She noted that she does not know of any other groups with such a rule. Journal of the American Medical Association Editor-in-Chief Catherine DeAngelis said, "I'm sure this is because of Sen. (Chuck) Grassley (R-Iowa)," who has disclosed millions of dollars in payments to leading doctors by medical companies. DeAngelis added, "I'm sure they're saying we'd better police this ourselves or the feds will." Grassley said the NASS rule "is impressive because of the sanctions it contains for violating the society's own code" (Burton, Wall Street Journal, 1/24).

'Ethical Makeover' for Medical Device Industry
In related news, the New York Times on Saturday examined how the medical device industry has begun an "ethical makeover" to address the "volatile issue of frequently undisclosed financial ties between companies and physicians." The "battles over how much companies, doctors and medical institutions disclose about their financial ties will continue," but "some experts on medical conflicts of interest, seeing the rapid fall of resistance by most major companies, say that a turning point has arrived," according to the Times.

Biomet, DePuy, Smith & Nephew and Zimmer -- the largest artificial hip and knee manufacturers -- in September 2008 agreed to operate under federal supervision to settle accusations by the Department of Justice that they used illegal practices to encourage physicians to use their products. In addition, other medical device companies "face continuing federal inquiries or are voluntarily taking house-cleaning measures" related to their financial ties with physicians, the Times reports. On Thursday, Grassley and Sen. Herb Kohl (D-Wis.) proposed the Physician Payments Sunshine Act (S 301), which would require pharmaceutical and medical device companies to disclose to HHS certain gifts and payments to physicians.

According to the Times, although several major pharmaceutical companies have announced plans to disclose their financial ties with physicians, similar efforts by medical device companies are "proving easier said than done." The "ties between medical device makers and physicians are often more entangled and can have a bigger impact on both patient care and product sales," the Times reports (Meier, New York Times, 1/24).